Friday, April 19, 2013

Morning lectures

Most residency programs have some sort of lecture series built in to the program, in order the satisfy ACGME regulations. In my first year of residency, we had two hours of lecture weekly at 7AM.

For PM&R residents, especially at my program, 7AM was really early. I mean, it was prohibitively early. Nobody seemed able to make it to lecture that early and the residents whined constantly about it. The response of the program director was to threaten us. One of the first emails I ever got from the PD was saying that we’d be put on probation if we missed or were late for too many lectures (and welcome to residency!).

The next year, the lectures were moved to 7:30AM. This was still too early. Finally, in my last year, they were moved to 8AM. Still, this was kind of early, especially for the PGY4s.

These lectures somehow seemed to bring out the worst in everyone. The residents would whine about them being too early, not useful, and complain about the threats of extra call or probation for no shows or latecomers. Moreover, the residents would take their sweet time getting back to work after the lecture. Yes, we all worked at different locations, but none of them were more than 30 minutes away from each other, much less TWO HOURS.

At the same time, the attendings and administrators didn’t show their best side either. Instead of scaling back their clinics during those mornings, a lot of attendings canceled their clinics altogether. I mean, is an attending really incapable of seeing a few patients alone one morning per week? Really? And the inpatient wards were a mess. Some attendings had to be yelled at by the chairman because they would refuse to see any patients or do absolutely any work until their resident showed up for the day, leaving the resident to do a day’s worth of work in half a day.

And the threats were unpleasant as well. The most popular threat was that we’d get extra call if we were late. One particularly stringent chief resident informed us that there was absolutely no excuse for being late. He said if we were in a car accident that morning, we would still be marked down as being late or absent.

Me: “You’re joking, right? You’d penalize someone if they were late because of a car accident?”

Chief: “What’s the difference? It’s just one extra call.”

Of course, they were idle threats. I don’t think anyone ever got extra call over being late; otherwise, the senior residents would have done the majority of call during that year.


  1. Anesthesia resident lectures are often at 6:30 in the morning. No one seemed to mind this too much unless you were on cardiac, because then you'd have to get there insanely early to get your room set up. Everyone kind of accepted this about cardiac, though, anyway. What residents tolerate is probably residency-specific.

  2. My lectures were at 7am and i was always on time, granted I was a 3rd year student at the time and I didn't mind but really felt bad for the residents, if they were late they would close the door and leave them out. I mean, 7 am is really early and much more for the people with families but it is what it is I guess.

  3. On surgery lectures are at 6:45AM and we go to the lecture after rounds.

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  5. My program chiefs got the bright idea to penalize late residents with extra call. The dean of the med school pointed out that it's totally unacceptable to use patient care responsibilities as punishment for a professionalism issue. I wonder if the ACGME would agree with his reasoning (I did). Besides, residency is hard enough without having EXTRA overnight call. The program found other ways to punish residents late for lecture.

  6. We have had attempts to schedule lectures at 7am. Our entire program's residents all said NO WAY. Seriously, we barely make the 8am lecture.

    Surgery and anesthesia are fields that start early, and are known to start early. When I last did surgery, rounds started at 6. So a 7 am lecture is like sleeping in.

    A 7am lecture for PM&R is impossible. I wouldn't go. If I wanted to be at the hospital at 7am, I would have applied to surgery. But I didn't, so I applied elsewhere. Our program keeps trying for the 7am, and we all flat out said we wouldn't be there.

  7. I'm just reading this and thinking of the luxury of having anything start as late at 7 am. Both parenting and anesthesia have ruined mornings for me.

  8. I almost thought this post was a joke mocking the perceptions some people have of PM&R...